Peripheral arterial insufficiency and the fine structure of the gastrocnemius muscle.

A detailed light- and electron microscopical study was carried out on biopsies from m. gastrocnemius of 14 male individuals with intermittent claudication. The morphometric data obtained showed a large number of significant correlations with clinical and physical parameters. Practically all sections also showed morphological abnormalities, such as a fibre necrosis, regeneration, angular fibres, fibre type grouping and abundant connective tissue. Finally, there were significant differences in the muscle fine structure between those patients recommended physical training and those selected for surgery. The results clearly show that the structure of the muscle fibres is well adapted to the functional circumstances. They also show that widespread fibre damage do occur in intermittently ischaemic musculature, even if no signs of macroscopical tissue damage are found at routine clinical examination. Furthermore, although the clinical and physical data on patients selected for physical training and vascular surgery respectively, are very similar, there seems to be other factors that clinically influence the differentiation of the patients into these two groups. When evaluating effects of different treatments on these two groups of patients, it is thus important to take into account that there may be differences in morphology even before they are subjected to the different treatments.